HomeMy WebLinkAboutT15N R1W SEC 18 LT 133 W110'T15N R1W
Sec. 18
Lot 133 WilO'
#051 - 231 - 31
Municipality of Anchorage ;,`;-,
1.1>,
t. t_
Development Services Department ;d_
a Building Safety Division •
�
On -Site Water and Wastewater Program, 4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99507 Page
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. Sw0901o1 PID Number: 051.231-31
of
Hama JUNE STURGEON
Wastewater System: ❑ New
M Upgrade
Aachen
POBOX 672025
ABSORPTION FIELD
Phone
688-9259 Number a ern`
3
0 Deep Trevi, 0 ShMbw Trench O fled O Mound O oder
LEGAL DESCRIPTION
Sal Rata
1.0 GPOFtt
Taal Depth from anginal (lade
5.0' Ft
Block- LaW 710' of BLM LOT 133 Subdinsch
Dean to ppe bottom from anon
1.8' FI.
beneath Gravel depth beath pipe
3.2' Ft
To nshp. 15N Rape 1 W Section 18
Fd added above onanu grade
0.8' Ft.
Gravel Length
56.0' Ft.
Well: New ❑ U rade
P9
Grtn
a &w,d
5.0 Ft.
Numbwal leer
1
Durance between lies
I
Ft
Classification (Proms. A B. C)
PRIVATE EXISTING
Total Depth
Cased to
Ft
Taal absorption rad
483 Fix
Pp Malene.
ASTM3034/F810
(Hwy
Dpe
suis wed Level
Ft
Installer
TWEED
TWEXCAVATION
Date /099ba
7/15/09
Yea
GPM
Poop Sew
Ft.
I CasingScot Above Ground
Ft
TANK
SEPARATION DISTANCES
p Septic 0 Holding 0 S.T.E.P. 0 Other.
To
From
Septic
Tank
Absorption
Field
Lift
Station
Rattling
Tank
>uoiiUPnvate
Sewer Line
M°r"'t'K'Wer
PREMIER PLASTICS
Capacity
1000 GM
Wes
100'+
1001+
251+
Material
HDPE
Number al Compartments
2
Skeane wale
100+
1001+
LIFT STATION ----------
La Lae
5+
10'4•
Sze
Sze
Gel
ajsd✓w
Farvtebon
5'+
10'+
'Pump on' level M
'Pump air . I
n
High waw warm M
n
Cutin Drain
NONE
KNOWN
Pump Mahe&
Electrical nms apecbpedonnsa bT
Remarks
EXISTING 1000 GALLON FIBERGLASS TANK PUMPED.
BENCH MARK
CRUSHED AND ABANDONED.
Locaron wa Desaptnn.
BOTTOM OF SIDING 4 POINT B
"atoned ed Eleveion.
100.00' Ft.
S&S Engineering
Inspections performed by: 15861 S. Birchwood ID. Rd. Dates: 1M 7/15/09
Ens in Stamp
OF
A
h P ""......
f./
!
Chuplake Alaska 99567 2nd 7/15/09
Development Services Department Approval
Conditional Approval Date:
lip - xoetat c co M .
�'�. c= -debt ter`
tst
tfC,,..C. �`..p:S.
ttt�`• 4. •L;,;.•
door.:
PP Y W. �—�-0�
Rev(Rev iewed and approved b : Date:
PERMIT NO SW090101
PAGE 2 OF 4
Municipality of Anchorage
DEVELOPMENT SERVICES DEPARTMENT - BUILDING SAFETY DIVISION
ON-SITE WATER AND WASTEWATER PROGRAM, 4.700 BRAGAW STREET
P.O. Box 196650 o Anchorage, Alaska 99519-6650 • Telephone: (907) 343-7904 • www.ci.anchorage.ak.us
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL W110' of BLM L0T133, SEC18, T15N, R1W P.I.D. NO. 051-231-31
LOT 1
CHWOOD
ACRES
r -
z
w
tJ
w
to
w
J
1-
O
33' B.L.M. ROAD &
UTILITY EASEMENT
DECK
EX STING 3
BEDROOM
HOUSE
33' B.L.M.
UTILITY E
RADIUS
RADIUS
1
1
1
1 1-
1w
LJ
LJ
LOT3t-
IIH1VOOD 1 D
ACRES 1
t' - 40'
NEW SHALLOW
TRENCH
P
491
M I D
OF
SEC
R111.
p'"c; ROBERT C. COWAN
ti 'CE -8801
tres
111i��f^.PLSsiA
PERMIT NO SW090101
PAGE 3 OF 4
Municipality of Anchorage
DEVELOPMENT SERVICES DEPARTMENT - BUILDING SAFETY DIVISION
ON-SITE WATER AND WASTEWATER PROGRAM, 4700 BRAGAW STREET
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone (907) 343-7904 • www.ci.anchorage.ak.us
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL W110' of BLM LOT 133, SEC18, T15N, R1W P.I.D. NO.
051-231-31
AD &
'RENT
BIRCHWOOD LP. ROAD
33' B.L.M. ROAD &
UTILITY EASEMENT
33' B.L.M. ROAD &
UTILITY EASEMENT
LOT 1
BIRCHWOOD
ACRES
100' wrI L RADIUS
DO' WELL
1
LOT 3
BIRCHWOOD
ACRES
10' UTILITY EASEMENT
-- 10' UTILITY EASEMENT
LOT 4
BIRCHWOOD
ACRES
100' WEIL RADIUS
EX STING 3
0 DROOP
MOUSE
6
MEw SHALLOW
TRENCH
LOT 149; SEC.18;
T15N; R111'
1.1
MIDDLE 110'
OF LOT 133;
SEC.18; T15N;
R 111'
100• WELL RADIUS
7
AIsROBERTGCd`MAN ••jV
NC •8 01 /S')
1111 `,,�_.10�1�
PERMIT NO SW090101
PAGE 4 OF 4
Municipality of' Anchorage
DEVELOPMENT SERVICES DEPARTMENT - BUILDING SAFETY DIVISION
ON-SITE WATER AND WASTEWATER PROGRAM, 4700 BRAGAW STREET
P.C. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: <907) 343-7904 • www.ci.anchorage.ak.us
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LecAL W110' of BLM LOT 133, SEC18, T15N, R1W P.I.D. NO.
051-231-31
TOP OF
TANK
= 88.4'
ST1 ST2 91.4'
FINAL GRADE 1 1 2" INSULATION
ORIGINAL
GRADE= 87.4'
87.6'
NEW
1000 GALLON
POLYETHYLENE
SEPTIC TANK
87.4'
CO1
MT2. CO2. MT1 CO1 = 88.2'
CO2 = 88.2'
FINAL GRADE
Ti INSULATION
CO1 = 85.6'
CO2 = 85.6'
MT2 = 82.4' MT1 = 82.4'
A
B
FCO
3.0'
21.2'
ST1
67.0'
67.9'
ST2
71.3'
72.0'
TMT
73.8'
74.8'
OBL1
74.2'
74.8'
DBL2
75.6'
76.2'
C01
100.7'
107.8'
MT1
102.1'
108.8'
CO2
130.0'
127.5'
MT2
131.4'
129.2'
•
NO WATER FOUND
72.6' B.O.H.
N. T. S.
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water 8 Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SW090101
Legal Description: T15N R1W SEC 18 LT 133 W110'
Design Engineer: 0003 S & S ENGINEERING
Owner Name: JUNE STURGEON
Owner Address: PO BOX 672025
CHUGIAK , AK 99567-0000
Date Issued: Jul 01, 2009
Expiration Date: Jul 01, 2010
Parcel ID: 051-231-31
Site Address: 018769 BIRCHWOOD LOOP RD
Lot Size: 36155 SO. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit Is for the construction of:
g Disposal Field ❑,/ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Date*
Date: —97/71g / / d'/
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
ON-SITE SEPTIC/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
ora
Parcel I.D. 0.51'7.31-3 I
Property owner(s) ��>✓ STU 240 Day phone
688- 926
Mailing address Po 130x 67 2.02.5 Zip Code
Site address 18761 S. Z:reatOcob /tP.Q 7 OltgiRK Zip Code AK. CS756 3?
Legal description (Sub'd, Block & Lot) %tWtsr //OR er 13t.t1 /er /33
Legal description (Township, Section & Range) 175/1/4.1; Stc,/si RIO
Lot Size 36, i 56- Sq. Ft. Number of Bedrooms 3
THIS APPLICATION IS FOR (gall that apply):
Absorption Field
Septic Tank
Holding Tank
Privy
Private Well
Water Storage
THIS APPLICATION IS AN:
Initial
Upgrade
Renewal
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwetlin• -n• n acro: = ,'th applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees:
Date of Payment:
Receipt Number:
(Rev. 11/05)
530 Waiver Fees:
/a6/0Y
04630 C_
Date of Payment:
Receipt Number:
4. ailaigam—,
i/.Y(��& S
ngzneeKing
w
1
-
MEALTNA THORRY
APPROVALS
SEWER& WATER
NUN O DSCNS
SEWER a WATER
INSPECTION
ROBERT C. COWAN .
CML ENGINEERING
June 25, 2009
MUNICIPALITY OF ANCHORAGE
Development Services Department
P.O. Box 196650
Anchorage, AK 99519
REFERENCE: West 110' of BLM Lot 133, Sec. 18, T15N, RI W
PH: 907-694-2979
FAX: 907-6941211
It is requested that you issue a permit to install a new 1000 gallon IIDPE septic tank
and a new shallow trench to serve the existing three bedroom house on the referenced
property .
ENGNEERINcsTwcs A test hole was excavated and a percolation test performed. The approximate location of
AND
REPORTS the test hole is located on the attached site plan. At the time of excavation (6/13/2009)
water was not found. After seven days of monitoring, no ground water was found.
We do not anticipate any adverse effects on neighboring wells, septic systems, reserve
areas or drainage patterns by the installation of the proposed septic system. The
construction of this system will not prevent any future development on any of the adjacent
properties.
WELL INSPECTION
&iLOWTEST
SITE PLANS
ROAD DESIGN
SOIL TEST
PERCCIATgN
TEST
STRUCTURAL&
MEOWRCAL
NSRECTIpB
ON Sal
WASTEWATER
DISPOSALSfSTEM
mica
If you requi = ddi onal information, please contact us.
Enclosure
Shafer, P.E.
15861 S. Birchwood Loop Road - Chugiak, Alaska 99567
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Legal Oesaiplion:
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(Feet)rec, 111,
Lete
Municipality of Anchorage
Development Services Department
Buliding Safety DMslon
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.orglonsito
(907)343-7904
SolisLLog - Percolation Test
J v&26 arvtf Z N
- rT OEMItfitS
•
10-
11- 4.O
12- is
13- : sort
14-
15-
18-
17-
18-
1g-
20 -
COMMENTS
Spm
Slope
WAS GROUND WATER
ENCOUNTERED?
IF TES, AT WHAT DEPTH?
Depth to Water After
Monitoring?
Date Perla med:
Township, Range, Se tion: 7/6/U f A/ (,Q ; Sttsc.
Site Plan
6
s t1 L.3111
Reading
Dale
Gross Time
Net Time
Deptl, lo Water
Not Orop
-) awnk
4 W°1
•3"
-7b
-50
3,4"
y/�rr
5"
30
40
51/4"
3/ "
3"
3o
90
33/U"
.3/4"
a"
W
/2,0
31/4"
3/4"
546'-1'
t -, mill
nen
rtn�tnnrryn NAIL ry V (mflMw,tt • PERC HOLE OtAMETER
TEST RUN BETWEEN (j' FT AND 7s FT
tee .V•jl 0- F l ,
PERFORMED BY: ••••5 • £ ti��% i N E p.
}A n7'{I 1 CERTIFY THAT THIS TE T W S
PERFORMED IN ACCORDANCE W ITPFALL STATE AF1D MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 6 /
Per RS
4.
/.Yi•" %1/47.."-
triS
te_t&S
ngrne2e=ning
reklAINATPIOI TY
APPROVALS
SEWERS WATER
LLAnJ O(fENSCPC
SEWER & WATER
.uvECraR
ENGMEERNG ST LADES
MID REPORTS
WELL INSPECTION
S ROW TEST
SITE RMa
RNDOESKIN
SOIL TEST
PEACOtAT10N
TEST
STRUCTURAL
NEO NACK
INSPECTIONS
CW SITE
WASTEWATER
DISPC$ALSfSTEN
DESIGN
ROBERT C. COWAN .
CML ENGINEERING
PH: 907694-2979
FAX: 907694-1211
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
REFERENCE: West 110' of BLM Lot 133, Sec.18, TI5N, RI W
June 24, 2009
GENERAL:
1. The scope of this project includes the installation of a new 1000 gallon HDPE
septic tank and a shallow septic trench to serve the existing three bedroom
residence located on the referenced property.
2. Construction shall be in accordance with the approved site plan and design
drawings, Municipal permit with any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal Regulations.
3. The contractor shall be responsible for obtaining any necessary underground
utility locates.
4. Unless specifically agreed otherwise, the property owner shall be responsible
for final grading areas subsequently depressed from soil settling.
5. Contractors installing wastewater disposal systems must be certified by the
Municipal Development Services Department or ADEC if required, for
system installations. Owners installing their own systems must also receive
prior approval from the respective agency.
SEPTIC TANK INSTALLATION:
1. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access. All HDPE
septic tanks are required to have a 4" monitoring pipe installed next to the
tank extending to the bottom of the tank.
15861 S. Birchwood Loop Road - Chugiak, Alaska 99567
Page 2
West 110' of BLM Lot 133; 6ee.16; T1 SN; Rt W
June 24, 2009, 2009
•
2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank.
3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade.
4. Septic tanks installed with less than 4 ft. of cover shall be insulated. All HDPE septic
tanks are required to be covered with a minimum of 2" direct burial insulation, and a
maximum of 4 feet of cover.
5. A foundation cleanout shall be installed one to four feet from the building foundation. In
the line between the tank and the leachfield there shall be two adjacent cleanouts (unless
an effluent pumping system exists within the septic tank). These cleanouts shall be
located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line,
shall be to clean toward the leachfield. The second cleanout shall be to clean toward the
septic tank.
6. Final grading over the septic tank shall be such that a positive slope exists away from the
septic tank.
ABSORPTION TRENCIUDRAINFIELD INSTALLATION:
I. Excavate the proposed trench to the dimensions shown on the design. The bottom of the
excavation shall be within 2 inches of level. If the sidewalls of the excavation become
smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock)
placement.
2. Once the gravel is installed, the distribution pipe is to be installed level with the
perforations faced downward. Gravel is then to be placed over the distribution pipe to
provide a minimum of 2 inches of cover over the pipe.
3. A silt barrier must be installed between the final gravel layer and the native soil backfill.
Ensure the silt barrier covers the entire gravel surface before placing backfill.
4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations
shown on the design, and extend a minimum of 12 inches above final grade. The portion
of the monitoring tube extending through the gravel shall be perforated from the bottom of
the trench to the invert of the distribution pipe. This is equivalent to the effective depth of
the gravel as noted on the design.
5. Backfill over the final gravel layer must not be less than twenty-four (24) inches.
Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The
finish grade over the trench must be mounded to prevent the formation of a depression
after settling.
Page 3
West 110' of BLM Lot 133; 8ee.18; T1 SN; MW
June 24, 2009, 2009
MINIMUM MATERIAL SPECIFICATIONS:
1. Any septic tank proposed for installation must be constructed by a Municipal approved
septic tank manufacturer.
2. The following pipe materials are approved for use in septic system installations in the
Municipality of Anchorage:
Type of Pipe Perforated Solid
Cast Iron Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM F810 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
Use of a type of pipe other than listed above must be approved by the inspecting engineer.
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical
Company Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or
equal).
5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed
between the final Ieachfield gravel layer and the native soil backfill.
6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3%
passing the #200 sieve.
7. When sand is being used as a filter material, its gradation specifications must conform to
current M.O.A. or D.E.C. requirements, which ever requirement applies.
Page 4
West 110' of BIM Lot 133; See.18; T15N; R1 W
June 24,2009,2009
INSPECTIONS:
Typically there will be a minimum of three (3) inspections required during the installation of the
wastewater disposal system. These inspections will occur as follows:
1. The first inspection must be conducted after the excavation of ditches, pits,
trenches, or beds and before the installation of any gravel. A septic tank may be
set in place, but may not be backfilled before this inspection.
2. The second inspection must be conducted after the placement of the silt barrier,
gravel, distribution lines, standpipes, cleanouts, and insulation, but before the
placement of any other backfill.
3. The final inspection is to occur upon final grading of the property.
Often there will be more than these 3 inspections required. Especially with the installation of
multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer
is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -
construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or
control in any way the contractors activities.
The owner shall contract with the contractor to perform the work outlined in these specifications
and plans and in accordance with the attached M.O.A. permit. There will be no contractual
arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be
the owner's representative and will inspect the work as stated above to document the contractors
activities. Final acceptance of the contractors work rests with the owner and the M.O.A.
S & S Engineering shall have no liability to the owner or to others for acts or omissions of the
contractor or any other persons performing work on this project or the failure of the contractor to
carry out the work in accordance with these construction documents. S & S Engineering's
inspecting engineer will not be responsible for the construction means, methods, techniques,
sequence, procedures or the safety precautions incident to this project.
CONTRACTOR / INSTALLER
GRE ANCHORAGE AREA BO"
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
/e/c, ;ilii/�>J„j ril
NAME ///MN'(; %��'»/4/J MAILING ADDRESS --SAA %5ri l/ir;//✓% PHONE
LOCATION )i Cctt!04 LOC? LEGAL DESCRIPTION �pW/U � cc 1 16 f c,r CU; Sit/
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
MANUFACTURERSIANSA (Id :LI MATERIAL (iO4C[;RICS
INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY IOC'(' GALLONS.
NUMBER OF
COMPARTMENTS
SEEPAGE PIT:
NUMBER OF PITS / DIAMETER (O& OR WIDTH.?
LINING MATERIAL Ri”( :
LENGTH 3, DEPTH 7
DIAMETER DEPTH 7 DISTANCE FROM: WELL
/ TOTAL
BUILDING FOUNDATION SZ'/ NEAREST LOT LINE cS' ABSORPTION AREA l/1�- (WALL AREA) SQ FT
ADDITIONAL ABSORPTION
WELL:
TYPE ,it? ! LL t'<.J�
BUILDING
FOUNDATION
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST
LOT LINE
(6-€/ tie� ldliC;141) DEPTH
NEAREST
SEWER LINE
DISTANCE FROM:
SEPTIC"c2 SEEPAGE P�
TANK c'c'' SYSTEM
OTHER SOURCES
DISAPPROVED
DISTANCES:
INSTALLED BY:
PIPE MATERIAL.
VtVeil /!el\ /?&5(.
LOT SLOPE:
REMARKS•
Form No. EQ -031
S PL
APPROVE
0 Et E GEOTECHNICAL Et DEVELOPMENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Russell Oyster Earl Ellis
694-2774 688-2280
Soils Et Foundations Land Development
\ SOIL LOG
\"\l> :cc e' tel' ; c,i.l-n
Performed for: Name: io'GC. \J.) dc\\�, M Tel. No.
Mailing Address: <a2 71/2'W0,kc's 66 Q_..wv6 "\: G7
Legal Description: W \\CONr:
�• \ 3 SfC Neic— 1 -*.a r7 - \i
Depth (feet) Soil Characteristics
0
1 -zz-^4 4 -e;-",01->a.)C Qac ./
2
3
4
5
6
7
8
9
10
11
12
—71
G `+.) \(\f. 'Ce ' 4, A, ' y 0 -re -Ph Qes 45 P L4'i
V `c5L•� C>_'zp,%) k-'\ 43Z � P, t. -
3P,.e1--Y .
S q N i-, � cL.q ALJ vx epG3 c$ —:e5
16
/1
- 5.�: •( c� N:?y l�¢p1J"Gi- - ANcz+,..1.•
e.„6 cWZ S`c,ty' -)c ,aJ caff C,H t
Ground Water Encountered: Yes '' No If yes, what depth t
Proposed Installation: Seepage Pit Drain Field
Comments: 2•€0cw cr-\e-cASU,2 a,,s9c7C-a7k_ ' ' x ('
Q t7 -&A aCoIA07z vgn44 P e w0'S cD
N 6
vs>'zac.ice
{")trcc A- vc3 -&s' . .ac, , c\ c21, Q1\.o06 i 2t. .4 -ta
Performed by: \". ,, Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage. AK 99507
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. O E I ' 2 51 - 31 COSA # n qi 0-305
1. GENERAL INFORMATION
Complete legal description W 110' og Lot 133; Sec 18; T15N; R1W
Expiration Date: 1.2. - 1 - 0 q
Location (site address) 18769 S. Birchwood Loop Chugiak, AK 99567
Current Property owner(s) JOAe Sturgeon Day phone 688-9259
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
PO Box 6722025 Chugiak, AK 99567
Day phone
Tim Rittal
Day phone 244-4472
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
TYPE OF WASTEWATER DISPOSAL:
Individual On-site 0
❑ 0
❑ 0
❑ 0
Individual Holding Tank
Community On-site
Public Sewer
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes.
ordinances, and regulations in effect at the ' e of installation.
Name of Firm S & S Engineering
Address 15861 S. Birchwood Loop Ch ak. q67/A
` 0
Engineer's Printed Name
5. DSD SIGNATURE
Approved for
Disapproved.
Conditional approval for
3
bedrooms.
Phone 694-2979
9
bedrooms, with the following stipulations:
`,k tt%.j OF 44, •
` �Q Cyo
••..
\
S'.••
:o`er: ON-SITE ';qGi=
: WATER AND : 1i1=
• WASTFWATER ;
• PROGRAM
0.,�•0)N 1 SO' 1N 1���,
ii
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: � 7J! P0-4--71—Original Certificate Date:'- " (- O 91
(Rev 11(05)
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Ht//Q 407 Int -5FC/5 -n5-711,/ R luJ Parcel ID: 051- 2 31-3/
A. WELL DATA ^0ILGEs pr`u02
Well type If A, B, or C provide PWSID # Well Log ( N) 0 'Liu 1 (4'7 5
t, Date competed MC Sanitary sea N) Wires properly protecte•O) Vf S
,I ri
Total depth 174 ft. Cased to 17 ft. Casing height (above ground) /0 in.
FROM WELL LOG AT INSPECTION
Date of test K VC
i
Static water level w Il ft. 443 ft.
Well production W g.p.m.
WATER SAMPLE RESULTS:
Coliform 4 colonies/100 mL Nitrate NO mg/L Other bacteria . a colonies/100 mL
Arsenic: fit0 ug/L date of sample: 6 / 0/0 ? Collected by: Si gfr p
eerf n
B. SEPTIC/HOLDING TANK DATA / /
Tank TypelMaterial SEPi1L///b%t
Tank size 000 gal. Number of Compartments a Cleanout6
Foundation cleanout(( N) /t5Depression over tank Wig) High water alarm (YL
fJcv 7#wx
Date of pumping — Pumper
C. ABSORPTION FIELD DATA
Date installed i/fa Soil rating 6.p.d.I14r ft2lbdrm) 1.0 System type StMa010 ler,C+r4
r
Length 534 r ft. Width S ft. Gravel below pipe 3, ft.
Total depth iAft. Eff. absorption area aft= Monitoring tube VC; Depression over field
mu, S7£TYl --
Date of adequacy test AVM Results (Pass/Fail) For 3 bedrooms
Fluid depth in absorption field before test = in. Water added= gat. New depth= in.
1 Absorption rate >_ '—g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y I9 type) /Up If yes, give date
% wcLC `t ?Mid Fra4,, "If . 'q,6 -
we Le_ CACIr7 C E Kyr UOE4T ret fT.ME .6115/09
Z s O g.p.m.
Date installed
Elapsed Time: — min. Final fluid depth — in.
D. LIFT STATION Min
Date installed Size in gallons Manhole/Access {YM)— —
'Pump on" level at _ in. 'Pum 1t<level at_ in. High water alarm level at
Datum Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot /cD " On adjacent lots /Cr, It
Absorption field on lot /0'7 f On adjacent Tots /GY) a
In.
Public sewer main N IF} Public sewer manhole/cleanout N /F7
1
Sewer /septic service line `CEJ a • Holding tank ill/n
r r
Animal containment areas CO 1 Manure/animal excrete storag
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 51r Property line +- Absorption field
Water main N/19 Water service line /lD 4 Surface water
/
J /
Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 0 y Building foundation
Water Service line AO y- Surface water
Curtain drain MOW 101O1014 Wells on adjacent Tots bap -/
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined roug' field inspections and
review of Municipal records at th bove systems re in
conformance with MOA CO • uide ' ln ei►ect n i a
Engineer's Printed Name
Date
Water main N /17
Driveway, parking/vehicle storage /e)!,
i
•
ter
r:d
f fr
'#i• ?
.....rr '
'1 A. Stofa i7'/
"I,I i
PR OFR'
I
COSA Fee $ 1 `finn 0
Date of Payment vl //9G�
I
003-q C_
Receipt Number
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
rt
M
P r rGC W, • •y
110r
r
A
<., *^c.i
tJ
t
-- 3 3 ' L4.1_ . r,, R. „1 C tr. 'f •
s t�•. ;K.f
N
ti
.t✓f<:.1-r '7.. ~-i7-0/
II
AS -BUILT
1 hereby certify that I have surveyed the following described
property. w ,,/ rF L r.' es'
fS 1 r.r Kflc' ^t
Anchorage Recording Precinct, Alaska, and that the improve-
ments situated thereon are within the Property lines and do not
overlap or encroach on the property lying adjacent thereto, that
no improvements on property lying adjacent thereto encroach
on the premises in question and that there are no roadways,
transmission lines or other visible easements on said property
except as indicated hereon.
Dated at Eagle River, Alaska
Isis^ ` In, day of ' _ >✓ /00 4'
ROBERT C. JO1INSON ;; :dr
SCALE: , Registered Land Surveyor No. MO -LS
1" or Lr Box 776356, Eagle River, Alaska 99577
Phone (907) 694-2543
SG$
SCS RcfM
Client Name
Project Name/II
Client Sample ID
Matrix
PWSID
1092566001
S & S Engineering
W 110'ofBLML133
Sec 18; TI 5N; RI W
Drinking Watcr
0
Printed Date/lime
Collected Date/Time
Received DateTime
Technical Director
06242009 9:36
06/10/2009 10:30
06/10/2009 15:55
Stephen C. Ede
Sample Remarks:
Parameter
Results
PQL
Units Method
Allowable Prep Analysis
Container ID Limits Dare
Date Inst
Metals by ICP/MS
Arsenic
Waters Department
ND
Total Nitrate/Nitritc-N ND
Microbiology Laboratory
Colony Count
Total Coliform
Fecal Coliform
0
0
0
5.00
ug/L EP200.8
C (<10) 06/15/09 06/18/09 NRB
0.100 mg/L SM20 4500NO3-F B (<10)
col/100mL SM20 92223
col/100mL SM20 92223
co1/100mL SM20 92223
A
A
A
(<200)
(<1)
(<1)
06/15/09 LCE
06/10/09 SDP
06/10/09 SDP
06/10/09 SDP
CA-51SLk
Time
APPLIr - NT FILLS -OUT UPPER HA,' ' ONLY a.c. 41`-. J.,; g .
roperty Owner
Mailing Address
R C. (`;: // 4- �!'F'! fas 5 r uretionf
5'!'{ 22 , /..jcY J.` 4G >- r /caccCJ C.'" Zip�., t-7 r'.
,:� <, ,--1/-//� Code % (�
,
Zip Code
Phone
l/,r L_,> '.: t('!
2' I-2 71- /a(,.r*.I.
Buyer ,+
Address
Lending Institution
Address
,47 -i'i./l,7 (; `. /7 C',,
P&,r 4
A /' 14, -,-et rit,, A If
C. it - t.." C./- w4 -'r •
. Zip Code CSC/cyC, i
Phone
2 7K- 5_,CO'
Realty Co. & Agent
Address
lC eJ f N 1
Zip Code
Phone
Legal Description
Street Location
vt/,-.... ! /C., /+ .,:-f r_4 5)" /.3/ = .c'� - •c.,, ! s- -7 /6-n/ 15 / UZ = . 4-'V
r
.7;llv"'r. ST, " /if ry/�i/c e'E /li Ty. %1r�7,ss 'a/,/(" "1/:l�i ,.
Type of Residence
Jki. Single Family
O Multiple Family
❑ Other
r./
No. of Bedrooms l-
'CONDITIONS OF APPROVAL
�j
�'7///rG„
l.! Eli
...V
Water Supply
Individual
O Community
O Public Utility
ATTACH WELL LOG. A well log is required for all wells drilled since June 1875.
For wells drilled prior to that date, give well depth (attach log If available).
Sewer Disposal
g Individual
❑ Public Utility
❑ Holding Tank
Well To Absorption Area
Well to Tank
Well Log Received
Year Individual Installed: 6 kr o/ - C / 1 l{ /t -e-• •�
When Connected to Public Utility
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
CA-51SLk
Time
Time
Time /n� P Q
^t 1 1 i_ 1/
Time ,,�`` pp
/]I 1`V o'Al ck t A o
Date
Date
Date
°l- v4-saIu.on
Date
Q q4 tA-°rci
Inspector
Inspector
Inspector
, \ V
Pica FlaciIP
Inspector
i yU 4 e+`SRAGE
Field Notes:
, •., •('..
Y i t
Pie ,LO
ENVIE It f.:A. .O - 1
fn L I) 2 1982
laiguat.,Er-
'c t �� RECEIVED
( ) APPROVED BEDROOMS
( 1i DISAPPROVED
( ) CONDITIONAL APPROVAL'
DATE ,"- 8.1-
'CONDITIONS OF APPROVAL
�j
�'7///rG„
l.! Eli
...V
`SII'-
BY' Tf- . f
Soils Rating
Date Sewer Installed
Well To Absorption Area
Well to Tank
Well Log Received
Septic Tank Size
72-023 l3/B21
M
September 16, 1982
Ralph and Sheila Sturgeun
SR 1 Box 2346 S. Birchwood Lp.
Chugiak, AY 99567
Subject: West 110 ft. of Lot 133, Section 15 T15N R1W S.M.
Approval for the individual sewer and water facilities cannot
be granted until the following items have been completed:
o The top of the well casing sealed with a sanitary seal so
that it is water tight.
o The depression or pit around the well casing needs to be
filled with impervious type soil so that it slopes away
from the well casing.
o Exposed electrical wires to the well head are in violation
of the Municipality of Anchorage codes and must be encased
in conduit.
o The water analysis report needs to be submitted to this
office from the Chem Lab, 5633 B Street, for our review.
o The septic tank pumped with a receipt submitted to this
department.
o Locate and expose the standpipe to the seepage pit and sep-
tic tank. The sewer system will need to be relocated if it
is within the 100' protection radius requirement. This is
to insure the minimum distance requirements are met between
the well and sewer system.
o A four (4) inch cast iron cleanout needs to he installed to
the septic tank and/or leaching area.
o An adequacy test needs to be performed on the existing
leaching area. This test will determine if the system is
adequate according to National Standards. A listing of
private firms performing the test is enclosed. This report
needs to be submitted to this office for our review.
Please notify this Department for a reinspection when the
noted discrepancies have been corrected. If there are any
further questions, please call this office at 264-4720.
Sincerely,
Robert C. Pratt
Associate Environmental Specialist
DEPARTMEN
825
#1: Time
Date
Insp
C), fiAm
11 -LJ -71 o%P,:
MUNICIPALITY OF ANCHORAGE
JF HEALTH AND ENVIRONMENT,
L Street, Anchoraaa. Alaska
26.4-4720
EnLlo
PROTECTION
99501
Ilia a ceived: Novem•er 1, 1977
Time #3: Time
Date Date
Insp Insp
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES'
Lending Institution Request Security Pacific Mortgage,
Mailing Address: 1011 East Tudor Road, Suite 190 Phone: 276-1933
Property Owner: Jim/Leslie Batchelder Phone: 688-2150
Mailing Address: Star Route A Box 645 99567
Legal Description: T15N R1W Section 18 W110' Lot 133
4 Single Family Residence:: (x)
Multiple Family Residence: ( )
Number of Bedrooms:
Three
Number of Bedrooms:'
Well System: Individual Well (x) Community/Public System ( )
it' 4. 4x upP147$
Permit # �` hepet-TR-Well 174'
Construction
J
Well Log on File
Bacterial Analysis
Sewage Disposal Systems on-site System kx) Public Utility ( )
/nr ►
Permit # Installed ;,;,.nx+-adr � ^a-44.;21nstaller ,a
Septic Tank Size tO b G% Manufacturer SvArNAJLA
Absorption Area(4.017( Soils Rate Material
Distances: Well to Septic
to Sewer Line
to Nearest Lot Line
9%
Tank Sg.S to Absorption Area
Nearest Lot line Absorption Area
MUNICIPALITY OF ANCHORAGL
Department of -Health and Environmental•Protedt
825 L Street, Anchorage, Alaska 99501
279-2511, ext. 224, 225
1.
Request for Approval of Individual Sewer and Water Facilities
Property Owner:
Mailing Address:
2. Name of Buyer:
'4 G/
4.2,4,,
Mailing Address:
eOpFIQTy
Phone :4F3R- .2/67I
JUST L,Si F.D�
Phone:
3. Lending Institution: SfCa /7/ /-4(/7 76 /72r4:
Mailing Address: Phone: 9,7 -
4. Realtor/Agent:
y(1i/l-rte /C: 1 F;gz ) Sid/e v F4e1/fUAC'sr-
Mailing Address: QJ__ a) , /00,7-HF/1/v C/yy// Phone: �2c7
5. Legal Description:
Street Location:
ID I/O ' /0/ 79.3 SC e Ti
3 , 6 /RC//wdo,O toot 47040
6. Single Family Residence: (v) Number of Bedrooms:
Multiple Family Residence: ( ) Number of Bedrooms:
3
1
7. Water Supply: *Individual Well (y< Public/Community System ( )
If Individual Well, well depth 17 q 1
If Community System, name of system
8. Sewage Disposal System: On-site System (vit Public System( )
If On-site System, date of installation: finP(OU6O % ( -4--
(2, go uci
-
(2,2ouci ro tbA'euoi sPrc,cg;
*NOTE: A well log is required on ALL wells drilled since 6/75.
MUNICIP ITV O ANCHORAGE
DEP OF EALTH &
ENVIRON NT +L PROTECTION
3/77
OC
41977
RE/C,IVED
P� ye' Two
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and, water Facilities
Legal'_Description: T15N R1W Section 18 W1101 Lot 133
Comments
ZM
ta(---0747
Affadavit Attached:
Letter Attached:
( )
Approved:
Disapproved:
Date: /77
Date: \\215`1�
Department Worksheet: I_ _
November 7, 1977
Jim Batchelder
Star Route A Box 645
Eagle River, Alaska 99567
Subject: Request for Approval of Individual Sewer and Water
Facilities on the W110' of Lot 133 Section 18
T15N R1W
This department made an 'Inspection of the agile subject
location. At this time the individual sewer system
consits of a septic tank and a drainfield. In order to
give approval of this sewer system an adequacy test must
be conducted upon it. Currently onl#hthe firm of R & M
Consultants, Inc. conduct this type of "flow -rate test".
After this test has beeen conducted, the septic tank will
need to be pumped for maintenance purposes. A copy of the
receipt for pumping neads to be sent to this department.
If there are any further questions, please contact this
office at 264-4720.
Sincerely,
Cory Willis, R.S.
Sanitarian
CW/ljh
cc: Secnnity Pacific Mortgage
1011 Last Tudor Road, Suite 190 99507
Sh'Irley Dewhurst
Dynamic Realty
501 West Northren Lights Boulevard 99503
R&M CONSULTANTS, INC.
EITIFHNEFRS
GEOLOGISTS
a1 ANNERS
FURVEYORS
December 7, 1977
Jim Batchelder
SRA Box 645
Chugiak, Alaska
5024 CORDOVA • BOX 6001 • ANCHORAGE. ALASKA 99502 • PH
R&M No. 751546
79-0403 • TLX
Subject: Drainfield Adequacy Test, Lot 33, Sec. 18, T 15N R 1W S.M. Alaska
Dear Mr. Batchelder:
On December 7, 1977, we conducted a test of the septic system on the above
described property.
The liquid level in the septic tank was monitored as water was added to the
system. The following table summarizes the measurements.
Time Liquid Level Below Meter Reading
Top of Standpipe in Gallons
Total
090-0
Gallons Added
11:05 7.1' 12302.5 0
11:20 7.4' 12372.5 70
11:30 7.25' 12427.0 110
11:47 7.25' 12529.0 200
The meter used was a Rockwell 5/8" standard water meter which had previously
been calibrated by R & M Consultants, Inc. The water was left running while
measurements were being taken to prevent freezing of the hoses and water
meter. A total of 26.5 gallons of water was allowed to run onto the ground.
If the 3 -bedroom residence on the property will house 6 people, the average
load on the system can be expected to be 450 gallons per day or 0.31 gallons
per minute. During the test the system accepted 200 gallons in 42 minutes
without a rise in water level. This is equivalent to 4.76 gallons per
minute.
Since the house on the lot was occupied at the time of the test, it can be
assumed that the drainfield was at its normal degree of saturation. We can
therefore conclude that the septic system is performing adequately for a
3 -bedroom residence.
ANCHORAGE FAIRBANKS
JUNEAU VALULL
L
0
December 7, 1977
Jim Batchelder
Page -2-
We appreciate this opportunity to be of service to you. If you have any
questions concerning this test or this letter, please do not hesitate to
contact us.
Very truly yours,
R & M CONSULTANTS, INC.
Stephanie Hoag
Staff Geologist
SH/JMB/kah
ion a
Jim McCaslin Brown, Ph.A�C
Head, Earth Sciences Department
3330
CI
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
Street, Anchorage, Alaska 99503 274-4561
Date Received 4/7/75
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
FI ill. _
1. Approval requested by: KASSLIIR AND COMPANY
Mailing Address: 319 5th Avenue 99501 Phone:
2. Property Owner: Neatfeld , Ilarmon 11. Phone:
Mailing Address: Birchwood Loop Road
3. Legal Description: W 110' of Lot 133, Soc 18, T15N, R1TV, SM
4. Location:
5. Type of facility to be inspected Single No. of bedrooms
6. Well Data:
A. Type B. Depth
C. Construction D. Bacterial Analysis Satisfactory
7. Sewage Disposal System:
A. Installed B. Installer
C. Septic Tank: 1. Size 2. Manufacturer
D. Seepage Pit: 1. Absorption Area 2. Material
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank , Absorption area , Sewer Lines
Nearest lot line , Other contamination
B. Foundation to septic tank , Absorption area
C. Absorption area to nearest lot line
EQ -034 (1/74) Page 1 of taw,
L,:gai Description
Lot i33, Sec 18, T15N, R1W, SM
Comments Approval pending escrow of funds for up grade of sewer system and well
prior to July 1, 1975.
Approve
e f s Disapproved Date 4/14/75
Approval ,Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
EQ -034 (1/74)
Date